Mixed connective tissue disease (MCTD) is a systemic disease identified by Sharp and coworkers in 1972, (1) which shows some of the clinical and pathological features of other connective tissue diseases such as systemic lupus erythematosus (SLE), systemic sclerosis (SS), and polymyositis. Although it is characterised by high concentrations of anti-U1RNP antibodies, the very definition of MCTD as a distinct entity is still under debate despite the number of immunogenetic, immunological, and clinical studies that have been carried out. (2 3)
Imaging of the joints in MCTD is based on traditional radiology. Features characteristic of SS (soft tissue atrophy, calcifications, tuftal resorption, distal interphalangeal joint erosions), of rheumatoid arthritis (RA) (juxta-articular osteoporosis, joint space narrowing, marginal erosions), and of SLE (joint deformities without erosions, osteonecrosis) have been described. (4) Magnetic resonance imaging (MRI) is better than conventional radiology in many instances because of its multiplanar capacity and higher sensitivity. (5) We describe here the MRI appearance of the hands in two patients with MCTD.
Two women, aged 32 and 25 years, were diagnosed with MCTD according to the criteria of Alarcon-Segovia and Villareal. (6) Disease duration was six and 24 months, respectively. Both patients showed arthritis of the wrist and of several metacarpophalangeal (MCP) and interphalangeal joints, as well as dorsal oedema of the hands, Raynaud's phenomenon, and xerophthalmia. Swelling of the parotid gland, myositis, and photosensitivity were...